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Review Article

Long-Term Metabolic Consequences in Patients with a History of Gestational Diabetes

[ Vol. 26 , Issue. 43 ]

Author(s):

Eleni Kousta*, Adamantia Kontogeorgi, Stephen Robinson and Desmond G. Johnston   Pages 5564 - 5572 ( 9 )

Abstract:


Gestational diabetes mellitus is a common metabolic complication of pregnancy. Universal guidelines on gestational diabetes have been impeded by the long-term controversies on its definition and screening strategies. The prevalence of gestational diabetes is rising all over the world, is significantly influenced by ethnicity and its rise is mainly attributed to increasing maternal obesity and age. Gestational diabetes mellitus has important long-term implications, including gestational diabetes recurrence, increased risk for developing type 2 diabetes, metabolic syndrome and cardiovascular disease for the mother. Gestational diabetes mellitus may be viewed as a chronic metabolic disorder that is identified in women during gestation and may provide a unique opportunity for the early identification and primary prevention of type 2 diabetes mellitus and cardiovascular disease in these women. In this mini-review, the evolution of screening tests for gestational diabetes and guidelines are briefly described and metabolic and cardiovascular long-term consequences of women with a history of gestational diabetes are summarized. A summary of our own St. Mary’s Hospital-UK Research series on long-term metabolic consequences of 368 women with a history of gestational diabetes of 3 different ethnic groups and 482 control women is also included. We found that approximately 2 years following delivery, 37% of women with a history of gestational diabetes had abnormal glucose concentrations, but, most importantly, even those who were normoglycaemic, postpartum displayed metabolic abnormalities on detailed testing. Future research needs to focus on the prevention of gestational diabetes long-term complications, but also in identification of pre-pregnancy predictors and risk reduction before conception.

Keywords:

Gestational diabetes, type 2 diabetes, metabolic consequences, definition, screening, cardiovascular disease, prevalence.

Affiliation:

Research in Female Reproduction Postgraduate Course, National and Kapodistrian University of Athens Medical School, Athens, Research in Female Reproduction Postgraduate Course, National and Kapodistrian University of Athens Medical School, Athens, Division of Diabetes, Endocrinology and Metabolism, Imperial College London, St. Mary’s Campus, Norfolk Place, London W2 1PG, Division of Diabetes, Endocrinology and Metabolism, Imperial College London, St. Mary’s Campus, Norfolk Place, London W2 1PG



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